EDITOR,—Scott A Murray and colleagues draw attention to the geographical relations between patients and general practitioners in an urban area.1 In rural areas lists are low, travel is a major factor for patients and doctors, and there is the additional, and potentially perverse, factor of rural practice units. Remuneration heavily based on capitation penalises rural practitioners, and rural practice units are intended to offset this partially. Unfortunately, no worthwhile limits are placed on the distribution of these payments, with the result that urban practices may be tempted to extend their range of …